Neuro: Neuroleptic Malignant Syndrome: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Neuroleptic Malignant Syndrome (NMS)🎧 A clear, high-yield breakdown of this life-threatening antipsychotic reaction – perfect for exam prep and real-life clinical scenarios.🧠 Key Learning Points📌 Definition• A rare but potentially fatal reaction to dopamine antagonist drugs, especially antipsychotics.• Characterised by ⬆️ temperature, 🤕 rigidity, 🤯 altered mental state, and 🔄 autonomic dysfunction.📌 Causes & Risk Factors• Triggered by antipsychotics (e.g. haloperidol, risperidone)• Sudden withdrawal of dopaminergic meds (e.g. levodopa)• High doses, depot preparations 💉• Rapid dose escalation• 🌞 Hot environment, dehydration• ♂️ Male sex, agitation, prior NMS episode📌 Pathophysiology• Dopamine blockade in CNS → disrupts thermoregulation & motor control• Muscle rigidity → rhabdomyolysis 💔• ⬆️ CK, metabolic acidosis• May involve ↑ glutamate toxicity📌 Symptoms• Fever 🌡️• Lead-pipe rigidity 🤕• Confusion, agitation• Autonomic instability: tachycardia, BP swings, sweating• Tremor, breathing difficulties🧠 Mnemonic: "FARM" – Fever, Autonomic, Rigidity, Mental status change📌 Differential Diagnosis• Serotonin syndrome• Malignant hyperthermia• Heat stroke 🥵• Anticholinergic toxicity• Sepsis, encephalitis• Catatonia, overdose🧠 Tip: NMS often lacks clonus (vs serotonin syndrome) and persists despite anticholinergics📌 Diagnosis• Clinical diagnosis 📋• Criteria: recent dopamine antagonist use + ⬆️ temp + rigidity + ≥5 supportive features• Features: ↑ CK, tachycardia, unstable BP, leukocytosis, tremor, acidosis, incontinence• Rule out mimics with labs, CT, LP📌 Management• 🚫 Stop causative drug• 🏥 Admit, often ICU• IV fluids, active cooling• Benzodiazepines for agitation 😴• Dantrolene (muscle relaxant) or bromocriptine (dopamine agonist) may be used• Consider dialysis if rhabdo severe• Avoid physical restraint📌 Complications• Rhabdomyolysis → acute kidney injury• Respiratory failure• DIC, seizures, arrhythmias• Pulmonary embolism, pneumonitis📌 Prognosis• Good with early treatment ⏱️• Mortality 5–11.6% if missed• Poorer outcomes if elderly, delayed treatment, severe fever, or comorbidities📎 More MSRA Resources for Neuroleptic Malignant Syndrome📝 Revision Notes: https://www.passthemsra.com/topic/neuroleptic-malignant-syndrome-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/neuroleptic-malignant-syndrome-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/neuroleptic-malignant-syndrome-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/neuroleptic-malignant-syndrome-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/neurology-for-the-msra/Hashtags#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #NeurolepticMalignantSyndrome